During COVID-19, Loneliness Linked to Depression and Suicidal Ideation

The ongoing lockdown to control the spread of the novel coronavirus disease 2019 (COVID-19) has raised concerns of exacerbated loneliness and mental health conditions. In a brief letter to the editor published in Psychiatry Research, researchers have now demonstrated that self-reported loneliness during the lockdown may be linked to depressive symptoms and suicidal ideation.

William D.S. Killgore, PhD, of the department of psychiatry at the University of Arizona, College of Medicine, Tucson, and colleagues administered the UCLA Loneliness Scale-3 and Patient Health Questionnaire-9 (PHQ-9) to a nationally representative sample of adults in the United States in the third week of the COVID-19 national emergency. They sampled people from all 50 states, developing a full sample of 1013 individuals (age range, 18-35 years; 567 women).

Mean scores were compared to previously published data to determine severity of loneliness. For depressive symptoms and suicidal ideation, scores were compared between dichotomized loneliness groups using analysis of covariance with age and sex as covariates.

The vast majority (93.6%) of the sample was sheltering in place, and 61.5% of respondents reported feeling mostly socially isolated. Loneliness was significantly higher in the sample compared to prior data (mean score, 43.8±13.5 vs 38.4±13.5; t1287, 6.31; d, 0.48; P <.0001), and 43% of the sample exceeded the cutoff for high loneliness (score ≥47).

Notably, lonely individuals reported significantly more depressive symptoms than those who were not lonely (mean score, 10.47±6.40 vs 4.45±4.74; F1,997, 299.49; P <.00001).

In the group reporting loneliness, 54.7% of individuals met clinical criteria for moderate to severe depression, compared to only 15.3% in the non-lonely group (odds ratio, 6.90; 95% CI, 5.10-9.33; P <.00001). These individuals were more likely to endorse suicidal ideation compared to non-lonely individuals (34.9% vs 4.5%; odds ratio, 10.97; 95% CI, 7.04-17.11; P <.00001).

The researchers noted that the large observed effect sizes of depression and suicidal ideation among the lonely group are “likely to have a tangible and meaningful impact when considered at the population level.” These mental health concerns may be worsened by economic despair and job loss.

“Efforts need to be directed toward finding novel and creative approaches for maintaining social connectedness while still following public health guidelines for minimizing virus transmission,” the researchers concluded.